Hip
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A 2020 study gave spironolactone 25 mg daily to sixteen Epstein-Barr virus ME/CFS patients, and found that 31% achieved full remission from their illness, and the other 69% observed improvements in their ME/CFS symptoms.
Spironolactone is a diuretic drug, which is also prescribed for high blood pressure and edema (fluid retention).
One 2016 study found that spironolactone has antiviral effects against EBV in vitro, by inhibiting EBV SM protein function. However, according to a calculation in this post, blood concentrations of spironolactone are too low to achieve the same antiviral effect in vivo, when you take this drug.
So the benefit of spironolactone for EBV ME/CFS may come from some other actions that this drug has in the body. One possibility is spironolactone's potential anti-inflammatory effects:
Spironolactone has potent anti-mineralocorticoid effects (it blocks the action of aldosterone by blocking the mineralocorticoid receptor). Ref: here.
This may thus make spironolactone anti-inflammatory, as "aldosterone promotes an inflammatory state characterized by vascular infiltration of immune cells, reactive oxidative stress, and proinflammatory cytokine production". Ref: here.
Spironolactone is generally a well-tolerated drug. Note that spironolactone lowers blood volume as well as blood pressure, and lowers testosterone levels. Spironolactone increases blood potassium levels, so potassium supplements are contraindicated when taking spironolactone. Spironolactone can cause gynecomastia in males if taken for long periods (eg a year).
Spironolactone is a diuretic drug, which is also prescribed for high blood pressure and edema (fluid retention).
One 2016 study found that spironolactone has antiviral effects against EBV in vitro, by inhibiting EBV SM protein function. However, according to a calculation in this post, blood concentrations of spironolactone are too low to achieve the same antiviral effect in vivo, when you take this drug.
So the benefit of spironolactone for EBV ME/CFS may come from some other actions that this drug has in the body. One possibility is spironolactone's potential anti-inflammatory effects:
Spironolactone has potent anti-mineralocorticoid effects (it blocks the action of aldosterone by blocking the mineralocorticoid receptor). Ref: here.
This may thus make spironolactone anti-inflammatory, as "aldosterone promotes an inflammatory state characterized by vascular infiltration of immune cells, reactive oxidative stress, and proinflammatory cytokine production". Ref: here.
Spironolactone is generally a well-tolerated drug. Note that spironolactone lowers blood volume as well as blood pressure, and lowers testosterone levels. Spironolactone increases blood potassium levels, so potassium supplements are contraindicated when taking spironolactone. Spironolactone can cause gynecomastia in males if taken for long periods (eg a year).